DISEASES OF THE EYE

BLEPHARITIS

Blepharitis is a common and ongoing condition where the eyelids become inflamed (swollen), with oily particles and bacteria coating the eyelid margin near the base of the eyelashes. This annoying condition causes irritation, itchiness, redness, and stinging or burning of the eyes. While the underlying causes of blepharitis aren't completely understood, it can be associated with a bacterial eye infection, symptoms of dry eyes or certain types of skin conditions such as acne rosacea.

Causes of blepharitis:
Everyone has bacteria on the surface of their skin, but in some people, bacteria thrive in the skin at the base of the eyelashes. Large amounts of bacteria around the eyelashes can cause dandruff-like scales and particles to form along the lashes and eyelid margins.

Symptoms of blepharitis include:
• Eye and eyelid irritation

• Crusting of the eyelid/eyelashes

• Itchiness of the eye

• Tearing

• Redness in the eyelid margins and in the eye

• Burning sensation

• Foreign body sensation (something in the eye)

Treatment of blepharitis: 
Warm compresses
 - Wet a clean washcloth with warm water, wring it out, and place it over your closed eyelids for at least one minute. Repeat two or three times, rewetting the washcloth as it cools. This will loosen scales and debris around your eyelashes. It also helps break down oil from nearby oil glands. 

Eyelid scrubs
 - Using a clean washcloth, cotton swab or commercial lint-free pad soaked in warm water, gently scrub the base of your eyelashes for about 15 seconds per eyelid. 

Antibiotic ointment
 - Your doctor may prescribe an antibiotic ointment. Using a clean fingertip or cotton swab, gently apply a small amount at the base of the eyelashes before bedtime. 

Nutritional therapy - Research suggests that a lack of certain nutrients may contribute to meibomian gland blepharitis. An imbalance of omega fatty acids has been found to cause abnormal secretions of the oil glands that help lubricate your eyes. Ask your doctor at Livermore Optometry Group about a proper diet and nutritional supplements to help treat this imbalance. 

Good hygiene
 - Because blepharitis can be an ongoing problem, you should regularly clean your skin and eyelids to keep blepharitis from returning.

CATARACTS

Cataract is a clouding of the eye's lens. When we look at something, light rays travel into our eye through the pupil and are focused through the lens onto the retina, a layer of light-sensitive cells at the back of the eye. The lens must be clear in order to focus light properly onto the retina. If the lens has become cloudy, this is called a cataract.

Causes of cataract include: 
* Age

o The lens is made mostly of water and protein. As we age, the lens continues to grow layers on its surface and hardens. Protein in the lens may clump together and become cloudy in some areas, preventing light from passing clearly through the eye. This cloudiness of the lens is what we call a cataract.

* Congenital or developmental cataracts

o This type of cataract can occur in infants or children. They may be hereditary or they can be associated with some birth defects. Some occur without any obvious cause.

* Other disease or medication

o These cataracts are caused by other eye diseases or previous eye surgery. Chronic disease can make you more likely to develop cataracts, such as diabetes or excessive use of steroid medications can spur development of this type of cataract as well.

* Traumatic cataracts

o These cataracts are related directly to an eye injury. Traumatic cataracts may appear immediately following injury, or they can develop several months or even years later.


Gradually, as cataracts progress, you may have symptoms such as:

* Painless cloudy, blurry or dim vision

* More difficulty seeing at night or in low light

* Sensitivity to light and glare

* Seeing halos around lights

* Faded or yellowed colors

* The need for brighter light for reading and other activities

* Frequent changes in eyeglass or contact lens prescription

* Double vision within one eye


Treatment of cataract: 
With cataract surgery, your eye's cloudy natural lens is removed and replaced with a clear artificial lens implant (called an intraocular lens, or IOL). Your doctor at Livermore Optometry Group will co-manage the procedure with a trusted ophthalmologist who will discuss the cataract surgery procedure, preparation for and recovery after surgery, the benefits and possible complications of cataract surgery, and other important information.

Cataract surgery is often performed as an outpatient procedure and does not require an overnight hospital stay.


CONJUNCTIVITIS

Conjunctivitis is the term used to describe swelling (inflammation) of the conjunctiva — the thin, filmy membrane that covers the inside of your eyelids and the white part of your eye (known as the sclera). Often this condition is called "pink eye."

The most common causes of conjuctivitis are:
• Infections (viral or bacterial)

• Allergies

• Irritation from something in the environment

Signs and symptoms of pink eye: 
* Mild eyelid swelling

* Redness in the white of the eye (conjunctiva) or the inner eyelid

* Increased tearing, mucous or pus production

* Eye irritation

* Foreign body sensation

* Itchiness of the eye

* Mild blurred vision due to mucus or pus

* Crusting of eyelashes in the morning, possibly gluing the eyes shut

Treatment includes: 
Viral conjunctivitis treatment

With viral conjunctivitis, symptoms can last from one to two weeks and then will typically disappear on their own. Discomfort can be minimized with cool compresses applied to the eye and cool artificial tears. This is typically the only treatment that is necessary. Severe cases can benefit from anti-inflammatory drops that should only be prescribed by your doctor at Livermore Optometry Group.

Bacterial conjunctivitis treatment

For bacterial conjunctivitis, your doctor at Livermore Optometry Group will typically prescribe antibiotic eye drops to treat the infection. Occasionally it is difficult to distinguish bacterial from viral conjunctivitis, and in this case drops will likely be prescribed.

Allergic conjunctivitis treatment

For allergic conjunctivitis, treatment often includes applying cool compresses to the eyes and using allergy or anti-inflammatory eye drops and artificial tears that have been cooled in the refrigerator.


DIABETIC RETINOPATHY

 

Diabetic retinopathy, the most common diabetic eye disease, occurs when blood vessels in the retina change. Sometimes these vessels swell and leak fluid or even close off completely. In other cases, abnormal new blood vessels grow on the surface of the retina.

 

What causes diabetic retinopathy?

When blood sugar levels are too high for extended periods of time, it can damage capillaries (tiny blood vessels) that supply blood to the retina. Over time, these blood vessels begin to leak fluids and fats, causing edema (swelling). Eventually, these vessels can close off, called ischemia. These problems are signs of non-proliferative diabetic retinopathy (NPDR).

Maintaining strict control of blood sugar and blood pressure, as well as having regular diabetic retinopathy screenings by your doctor at Livermore Optometry Group, are keys to preventing diabetic retinopathy and vision loss. Controlling blood sugar and also help to prevent the development of cataracts, as diabetes is a risk factor for cataracts.

 

Will I have symptoms?

You can have diabetic retinopathy and not be aware of it, since the early stages of diabetic retinopathy often don't have symptoms.

As the disease progresses, diabetic retinopathy symptoms may include:

* Spots, dots or cobweb-like dark strings floating in your vision (called floaters)

* Blurred vision

* Vision that changes periodically from blurry to clear

* Blank or dark areas in your field of vision

* Poor night vision

* Colors appear washed out or different

* Vision loss

Diabetic retinopathy symptoms usually affect both eyes.

 

What is the treatment for diabetic retinopathy?

The best treatment for diabetic retinopathy is to prevent it. Strict control of your blood sugar will significantly reduce the long-term risk of vision loss. Treatment usually won't cure diabetic retinopathy nor does it usually restore normal vision, but it may slow the progression of vision loss. Without treatment, diabetic retinopathy progresses steadily from minimal to severe stages.

 

DRY EYE SYNDROME

 

When you blink, a film of tears spreads over the eye, making the surface of the eye smooth and clear. Without this tear film, good vision would not be possible.

 

Sometimes people don't produce enough tears or the right quality of tears to keep their eyes healthy and comfortable. This condition is known as dry eye.

 

Causes of Dry Eye Syndrome include:

Hormonal changes are a main cause of dry eye syndrome, causing changes in tear production. The hormonal changes associated with menopause are one of the main reasons why women are most often affected by dry eye.

Conditions that affect the lacrimal gland or its ducts – including autoimmune diseases like lupus and rheumatoid arthritis – lead to decreased tear secretion and dry eye.

Tear secretion also may be reduced by certain conditions that decrease corneal sensation. Diseases such as diabetes and herpes zoster are associated with decreased corneal sensation. So is long-term contact lens wear and LASIK surgery.

A wide variety of common medications, both prescription and over-the-counter, can cause dry eye by reducing tear secretion. Be sure to tell your doctor at Livermore Optometry Group the names of all the medications you are taking, especially if you are using:

* Diuretics for high blood pressure

* Beta-blockers for heart or high blood pressure

* Antihistamines for allergies

* Sleeping pills

* Anti-anxiety medications

* Pain relievers

 

Dry eye symptoms usually include:

• Stinging or burning eyes

• Scratchiness

• Stringy mucus in or around the eyes

• Excessive eye irritation from smoke or wind

• Excess tearing

• Discomfort when wearing contact lenses

 

Treatment options for Dry Eye Syndrome are:

Adding tears

Eyedrops called artificial tears are similar to your own tears. They lubricate the eyes and help maintain moisture. Artificial tears are available without a prescription. There are many brands on the market, so you may want to try several to find the one you like best.

Preservative-free eyedrops are available for people who are sensitive to the preservatives in artificial tears. If you need to use artificial tears more than six times a day, preservative-free brands may be better for you.

Conserving your tears

Conserving your eyes' own tears is another approach to keeping the eyes moist. Tears drain out of the eye through a small channel into the nose (which is why your nose runs when you cry). Your doctor at Livermore Optometry Group may close these channels either temporarily or permanently. This method conserves your own tears and makes artificial tears last longer.

A temporary method of closing the channels may involve the use of punctal plugs. The plugs are inserted into the punctum (tear duct) and work much like a dam by blocking your eye's drainage system.

Omega-3

Some people may find dry-eye relief by supplementing their diet with omega-3 fatty acids, which are found naturally in foods like oily fish (salmon, sardines, anchovies) and flax seeds. Ask your doctor at Livermore Optometry Group if you should take supplements of omega-3 fatty acids and, if so, in what form and dosage.

GLAUCOMA

 

Glaucoma is a disease that damages your eye's optic nerve. It usually happens when fluid builds up in the front part of your eye. That extra fluid increases the pressure in your eye, damaging the optic nerve.

It is estimated that three million Americans have glaucoma, but only about half of them know that they have glaucoma. Glaucoma is a leading cause of blindness for people over 60 years old. But blindness from glaucoma can often be prevented with early treatment. When glaucoma develops, usually you don’t have any early symptoms and the disease progresses slowly. In this

way, glaucoma can steal your sight very gradually. Fortunately, early detection and treatment (with glaucoma eyedrops, glaucoma surgery or both) can help preserve your vision.

 

Causes of Glaucoma include:

Glaucoma causes include elevated eye pressure (called intraocular pressure or IOP) due to the eye’s inability to drain fluid efficiently.

Some people have a type of glaucoma called normal tension or low tension glaucoma. Their eye pressure is consistently low, but optic nerve damage and visual field loss still occur.

Congenital glaucoma is a rare type of glaucoma that develops in infants and young children. It can be hereditary, and it happens when the eye’s drainage system doesn’t develop fully or correctly before birth.

Glaucoma can often be caused by another eye condition or disease. This is known as secondary glaucoma. For example, someone who has a tumor or people undergoing long-term steroid therapy may develop secondary glaucoma. Other causes of secondary glaucoma include:

* Eye injury

* Inflammation of the eye

* Abnormal blood vessel formation from diabetes or blood vessel blockage

* Use of steroid-containing medications (pills, eyedrops, sprays)

* Pigment dispersion, where tiny fragments or granules from the iris (the colored part of the eye) can circulate in the aqueous humor (the fluid within the front portion of the eye) and block the trabecular meshwork, the tiny drain for the eye’s aqueous humor

 

The risk factors for developing Glaucoma include:

People with more risk of developing glaucoma include people who:

* are over age 40

* have family members with glaucoma

* are of African or Hispanic heritage

* are of Asian heritage (Asians are at increased risk of angle closure glaucoma and Japanese are at increased risk of low tension glaucoma)

* have high eye pressure

* are farsighted or nearsighted

* have had an eye injury

* have corneas that are thin in the center

* have diabetes, migraines, high blood pressure, poor blood circulation or other health problems affecting the whole body

Talk with your doctor at Livermore Optometry Group about your risk for getting glaucoma. People with more than one of these risk factors have an even higher risk of glaucoma.

 

Glaucoma treatment include:

How your glaucoma is treated will depend on your specific type of glaucoma, the severity of your disease and how well it responds to treatment.

 

Glaucoma medication

Medicated eye drops are the most common way to treat glaucoma. These medications lower your eye pressure in one of two ways — either by reducing the amount of fluid created in the eye or by helping this fluid flow out of the eye through the drainage angle.

These eyedrops must be taken every day. Just like any other medication, it is important to take your eyedrops regularly as prescribed by your doctor at Livermore Optometry Group.

Once you are taking medications for glaucoma, your ophthalmologist will want to see you regularly. You can expect to visit your doctor about every 3–6 months. However, this can vary depending on your treatment needs.

 

Glaucoma surgery

In some patients with glaucoma, surgery is recommended. Glaucoma surgery improves the flow of fluid out of the eye, resulting in lower eye pressure.

 

MACULAR DEGENERATION

Age-related macular degeneration (AMD) is a deterioration or breakdown of the eye's macula. The macula is a small area in the retina – the light-sensitive tissue lining the back of the eye. The macula is the part of the retina that is responsible for your central vision, allowing you to see fine details clearly.

 

Causes of Macular Degeneration include:

The condition is caused by a formation of deposits called drusen under the retina, and in some cases, the growth of abnormal blood vessels under the retina. With or without treatment, macular degeneration alone almost never causes total blindness. People with more advanced cases of macular degeneration continue to have useful vision using their side, or peripheral vision.

Symptoms of Macular Degeneration:

With macular degeneration, you may have symptoms such as blurriness, dark areas or distortion in your central vision, and perhaps permanent loss of your central vision. It usually does not affect your side, or peripheral vision. For example, with advanced macular degeneration, you could see the outline of a clock, yet may not be able to see the hands of the clock to tell what time it is.

In many cases, macular degeneration's impact on your vision can be minimal.

When macular degeneration does lead to loss of vision, it usually begins in just one eye, though it may affect the other eye later.

Many people are not aware that they have macular degeneration until they have a noticeable vision problem or until it is detected during an eye examination.

Treatment of Macular Degeneration include:

Dry AMD and nutritional supplements

Unfortunately, at this time there is no single proven treatment for the dry form of macular degeneration. However, a large scientific study has shown that antioxidant vitamins and zinc may reduce the impact of macular degeneration in some people by slowing its progression toward more advanced stages.

Wet macular degeneration treatment

Treating the wet form of macular degeneration may involve the use of anti-VEGF treatment, thermal laser treatment or photodynamic therapy (PDT). Treatment of wet macular degeneration generally reduces—but does not eliminate-- the risk of severe vision loss.

Vision rehabilitation and support

With vision rehabilitation, people with low vision can learn new strategies to accomplish their daily activities. With new techniques and devices, people with advanced vision loss can regain their confidence and live independently.

Low-vision aids for macular degeneration

There are many devices specifically designed to help people with low vision function better. Different devices are available for different tasks. A trained professional can help you understand which device is best for accomplishing your particular needs. Training and practice are also important in order to become skilled at using any device.

See our Low Vision section under the Services tab for more information on how to get a Low Vision Evaluation with your doctor at Livermore Optometry Group.

RETINAL DETACHMENT

The retina is the light-sensitive tissue lining the back of our eye. Light rays are

focused onto the retina through our cornea, pupil and lens. The retina converts the light rays into impulses that travel through the optic nerve to our brain, where they are interpreted as the images we see. A healthy, intact retina is key to clear vision.

Usually, the vitreous moves away from the retina without causing problems. But sometimes the vitreous pulls hard enough to tear the retina in one or more places. Fluid may pass through a retinal tear, lifting the retina off the back of the eye – much as wallpaper can peel off a wall. When the retina is pulled away from the back of the eye like this, it is called a retinal detachment.

 

Causes of a Retinal Tear or Detachment include:

Vitreous gel, the clear material that fills the eyeball, is attached to the retina in the back of the eye. As we get older, the vitreous may change shape, pulling away from the retina. If the vitreous pulls a piece of the retina with it, it causes a retinal tear. Once a retinal tear occurs, vitreous fluid may seep through and lift the retina off the back wall of the eye, causing the retina to detach or pull away.

Symptoms of a Retinal Tear or Detachment can include the following:

• A sudden increase in size and number of floaters, indicating a retinal tear may be occurring

• A sudden appearance of flashes, which could be the first stage of a retinal tear or detachment

• Having a shadow appear in the periphery (side) of your field of vision

• Seeing a gray curtain moving across your field of vision

• A sudden decrease in your vision

Contact your doctor at Livermore Optometry Group immediately or seek immediate medical attention if any of these symptoms arise.

Treatment options for a Retinal Tear or Detachment include:

A retinal tear or a detached retina is repaired with a surgical procedure. Based on your specific condition, your ophthalmologist will discuss the type of procedure recommended and will tell you about the various risks and benefits of your treatment options.

Ph: 925-447-3883 | Fax: 925-447-2957

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Livermore Optometry Group

1800 Fourth Street,

Livermore, CA 94550

Phone. 925-447-3883

Fax. 925-447-2957